Individual provider · Type 1 NPI

Mitchell Shane Mallard, LMHC-S

Mental Health Counselor · Raleigh, NC

NPI number 1902490980 Active

Practice location

8406 Six Forks Rd Ste 104
Raleigh, NC 27615-3075

Call (919) 424-6045 Map

Fax (617) 807-0958

Mailing address

1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XS8258 (NC)

Mental Health Counselor: Definition to come...

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About NPI 1902490980

Mitchell Shane Mallard, LMHC-S's National Provider Identifier is 1902490980, issued on Feb 22, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Raleigh, NC. The record was last updated on Feb 22, 2021.